Deterioro cognitivo asociado a radioterapia en tumores cerebrales

Introduction: There is limited knowledge about the influence on cognitive functions of the treatments for brain tumors based on radiotherapy (RT). Objective: To review the works conducted in recent years about the effects of RT on cognition in brain tumors. Method: Using EndNote software X5, articles containing “radiotherapy” and “cognition” in its title, keywords, abstracts or main text in the years 2009-2011 were extracted. Also, an extensive search through the references of articles taken was done. Those works that did not reflect the relationship between RT and the development of cognitive impairment or did not focus on brain tumors were disregarded. Results: 14 articles were selected: 7 originals, 6 reviews, and 1 opinion article. The findings focused on three aspects: a) cognitive impairment due to the RT, b) risk factors for cognitive impairment induced by RT c) time from the application of RT to the onset of cognitive impairment. Conclusions: The new studies confirm findings of recent decades, namely that the functions most commonly affected are attention, memory and learning, psychomotor and executive functions; that there are identifiable risk factors for cognitive impairment associated to RT; and that alterations in cognitive function after RT usually occur after a long period of time.Introducción: Existe un limitado conocimiento acerca de la influencia sobre las funciones cognitivas de los tratamientos para los tumores cerebrales basados en la radioterapia (RT). Objetivo: Realizar una revisión actualizada de los trabajos desarrollados en los últimos años acerca de los efectos de la RT sobre la cognición en los tumores cerebrales. Método: Mediante el software EndNote X5 se extrajeron los artículos que contenían “radiotherapy” y “cognition” tanto en su título, como en palabras claves, abstracts o contenidos en los años 2009-2011. Asimismo, se realizó una búsqueda ampliada a través de las referencias de los artículos extraídos. Se descartaron aquellos artículos en los que no se reflejase la relación entre RT y el desarrollo de alteraciones cognitivas o no se centraran en tumores cerebrales. Resultados: 14 artículos fueron seleccionados: 7 originales, 6 revisiones y 1 artículo de opinión. Los hallazgos se centraron en 3 aspectos: a) alteraciones cognitivas debidas a la RT; b) factores de riesgo para el desarrollo de deterioro cognitivo inducido por la RT; c) tiempo transcurrido desde la aplicación de la RT hasta la aparición de las alteraciones cognitivas. Conclusiones: Los nuevos estudios confirman hallazgos de las últimas décadas, principalmente que las funciones más comúnmente afectadas son la atención, la memoria y el aprendizaje, la psicomotricidad y las funciones ejecutivas; que existen algunos factores de riesgo identificables para el desarrollo de deterioro cognitivo asociado a la RT; así como que las alteraciones en la función cognitiva tras la RT suelen aparecer de manera evidente después un largo período de tiempo

State of the art and new directions of Quantitative Electroencephalography use in Differential Diagnosis of ADHD

Advances in technology in recent years have made the use of quantitative electroencephalogram more accessible to clinicians. The incorporation of normative databases in QEEG studies and the possibility of detecting different electroencephalographic patterns in patients with a given pathology, despite showing an apparent symptomatology homogeneity, make it an interesting source of information. The relationship of these patterns with a possible response to treatment or with prognostic estimates would justify its inclusion as a routine test in the process of the differential diagnosis of ADHD. In this paper, we present the possible benefits of the use of QEEG in the differential diagnosis of ADHD, the different electroencephalographic patterns associated with ADHD most common in the literature, and a case showcasing the use of the technique in a patient with ADHDEstado de la cuestión y uso de la electroencefalografía cuantitativa en el diagnóstico diferencial del TDAH. El avance de la tecnología en los últimos años ha hecho que el uso del electroencefalograma cuantitativo sea más accesible a los clínicos. La incorporación de bases de datos normativas en los estudios de QEEG y la posibilidad de detectar diferentes patrones electroencefalográficos en pacientes con una patología determinada, a pesar de mostrar una aparente homogeneidad sintomatológica, hacen que sea una fuente de información interesante. La relación de estos patrones con una posible respuesta a tratamientos o con estimaciones pronósticas justificarían su inclusión como prueba rutinaria en el proceso de diagnóstico diferencial del TDAH. En este trabajo se presentan los posibles beneficios del uso del QEEG en el diagnóstico diferencial del TDAH, los diferentes patrones electroencefalográficos asociados al TDAH más comunes en la literatura y un caso ilustrativo del uso de la técnica en un paciente con TDA

Neurofeedback de puntuaciones z (live z-score training neurofeedback). Regulación y control del patrón eeg en poblaciones clínicas

Tesis Doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Psicología, Departamento de Psicología Biológica y de la Salud. Fecha de Lectura: 16-07-202

Are cognitive interventions effective in alzheimer´s disease? a controlled meta-analysis of the effects of bias

Objective: There is limited evidence about the efficacy of cognitive interventions for Alzheimer's disease (AD). However, aside from the methodological quality of the studies analyzed, the methodology used in previous meta-analyses is itself a risk of bias as different types of effect sizes (ESs) were calculated and combined. This study aimed at examining the results of nonpharmacological interventions for AD with an adequate control of statistical methods and to demonstrate a different approach to meta-analysis. Method: ESs were calculated with the independent groups pre/post design. Average ESs for separate outcomes were calculated and moderator analyses were performed so as to offer an overview of the effects of bias. Results: Eighty-seven outcomes from 19 studies (n 812) were meta-analyzed. ESs were small on average for cognitive and functional outcomes after intervention. Moderator analyses showed no effect of control of bias, although ESs were different from zero only in some circumstances (e.g., memory outcomes in randomized studies). Cognitive interventions showed no more efficacy than placebo interventions, and functional ESs were consistently low across conditions. Conclusions: cognitive interventions delivered may not be effective in AD probably due to the fact that the assumptions behind the cognitive interventions might be inadequate. Future directions include a change in the type of intervention as well as the use of outcomes other than standardized tests. Additional studies with larger sample sizes and different designs are needed to increase the power of both primary studies and meta-analyses

Individual alpha peak frequency, an important biomarker for live Z-Score training neurofeedback in adolescents with learning disabilities

Learning disabilities (LDs) have an estimated prevalence between 5% and 9% in the pediatric population and are associated with difficulties in reading, arithmetic, and writing. Previous electroencephalography (EEG) research has reported a lag in alpha-band development in specific LD phenotypes, which seems to offer a possible explanation for differences in EEG maturation. In this study, 40 adolescents aged 10–15 years with LDs underwent 10 sessions of Live Z-Score Training Neurofeedback (LZT-NF) Training to improve their cognition and behavior. Based on the individual alpha peak frequency (i-APF) values from the spectrogram, a group with normal i-APF (ni-APF) and a group with low i-APF (li-APF) were compared in a pre-and-post-LZT-NF intervention. There were no statistical differences in age, gender, or the distribution of LDs between the groups. The li-APF group showed a higher theta absolute power in P4 (p = 0.016) at baseline and higher Hi-Beta absolute power in F3 (p = 0.007) post-treatment compared with the ni-APF group. In both groups, extreme waves (absolute Z-score of ≥1.5) were more likely to move toward the normative values, with better results in the ni-APF group. Conversely, the waves within the normal range at baseline were more likely to move out of the range after treatment in the li-APF group. Our results provide evidence of a viable biomarker for identifying optimal responders for the LZT-NF technique based on the i-APF metric reflecting the patient’s neurophysiological individualit

Efficacy of Live Z-Score Neurofeedback Training for Chronic Insomnia: A Single-Case Study

Objective/Background: Insomnia is the most common sleep disorder in the general population. Pharmacological treatments have shown efficacy in the short term, yet the symptoms return once the treatment has been withdrawn. In the search for treatment options with long-lasting effects, neurofeedback (NF) has arisen as a therapeutic option. Neurofeedback is the application of operant conditioning to brain activity. The aim of this work is to show the effectiveness of Live Z-Score NF training (LZT), a paradigm within the field of NF, in a case of insomnia. Participants: A 32-year-old male with chronic insomnia since his adolescence. Methods: Thirty 35-min sessions of qEEG-guided LZT using patient’s highly preferred feedback. The main outcomes of this study were the patient’s qEEG metrics and a visual analog scale of sleep quality throughout the intervention. Results: qEEG-guided LZT showed an improvement of 90.63% of the patient’s qEEG metrics and an 82.55% relief of the clinical symptoms after 30 NF sessions. Conclusions: Although more research is needed to establish that NF based on Live Z-Score is effective for insomnia, our results suggest that NF might be a therapeutic alternative for the treatment of insomnia

Enhancing the effects of neurofeedback training: the motivational value of the reinforcers

The brain activity that is measured by electroencephalography (EEG) can be modified through operant conditioning, specifically using neurofeedback (NF). NF has been applied to several disorders claiming that a change in the erratic brain activity would be accompanied by a reduction of the symptoms. However, the expected results are not always achieved. Some authors have suggested that the lack of an adequate response may be due to an incorrect application of the operant conditioning principles. A key factor in operant conditioning is the use of reinforcers and their value in modifying behavior, something that is not always sufficiently taken into account. This work aims to clarify the relevance of the motivational value versus the purely informational value of the reinforcer. In this study, 113 subjects were randomly assigned two different reinforcer conditions: a selected reinforcer—the subjects subjectively selected the reinforcers—or an imposed reinforcer— the reinforcers were assigned by the experimenter—and both groups undertook NF sessions to enhance the sensorimotor rhythm (SMR). In addition, the selected reinforcer group was divided into two subgroups: one receiving real NF and the other one sham NF. There were no significant differences between the groups at baseline in terms of SMR amplitude. After the intervention, only those subjects belonging to the selected reinforcer group and receiving real NF increased their SMR. Our results provide evidence for the importance of the motivational value of the reinforcer in Neurofeedback succes

Technical-Tactical Analysis of The Players of the Left and Right Wing in Elite Soccer

In today's soccer, teams are increasingly better trained both physically and tactically, hence different game styles can be identified and differences between them reduced. However, without an exhaustive analysis of reality, the view can lead to the extraction of erroneous conclusions, and what seems to be a team with a marked offensive profile is a mere illusion, resulting to be a team that develops a perfectly balanced game. In this paper, an analysis of technical-tactical performance of players who occupied both wings in an elite team was made, taking as reference the Spanish national soccer team as the model of international game to imitate in the last decade. The development of this paper was located within the observational methodology, using the polar coordinates technique for the analysis of the obtained data. The results showed how, despite identifying offensive profiles within technical-tactical performance of players that occupied the outer wings or lanes of the playing field, their tactical means and orientations diverged from each other. The results showed a more offensive profile and with higher technical complexity of players that occupied the left wing, while players that held the right wing showed a more defensive and recuperative profile, indicating a less vertical and complex style of play at a technical level with the forward as an offensive reference

Neuroaxial anesthesia caused paraplegia: a case report

Patients who undergo; anesthesia, neuraxial analgesia, or some type of neuraxial blockage are exposed to multiple complications. 33-year-old male patient, suffers a femur fracture with a long oblique trace causing pain and functional limitation for movements. Surgical resolution is determined using neuraxial block at L2-L3 level, and intravenous sedation. During his postoperative follow-up, a decrease in strength was confirmed in the lower limbs with 0/5 on the Daniels scale, 100% sensitivity without sphincter control, steroids were prescribed along with magnetic resonance imaging and a neurosurgical evaluation was requested. The MRI shows bulging of the fibrous annulus that obliterates the epidural fat and makes contact with the thecal sac in the L5-S1 intervertebral disc level. The neurosurgery service prescribes rehabilitation sessions at home, electrostimulation and neuropathic medications. Patient was discharged with rehabilitation sessions at home and medical treatment. In his last consultation, an evaluation from the psychiatry department was requested for ideas of disability, hopelessness, fantasies of death without a suicide plan related to limitations and loss of functionality. Patient does not return to external follow-up, cannot be located

The neurobiology of splitbrain crayfish

Background: They crayfish brain is segmented into two symmetrical hemiganglia. Normally both hemiganglia are in direct communication through a series of well-defined neural bridges that cross de midline to form reciprocal cross connections.Methods: An original study was carried out in the Department of Physiology of the Faculty of Medicine, UNAM during the period from August 2019 to August 2020. 13 Crayfish Procambarus clarkii weighing between 1g to 30g were used. Each eyestalk of the animals was tied to a displacement transducer coupled with a polygraph so that optomotor or electrical activity was bilaterally recorded. The separation of the right from the left hemiganglia from the cerebral or supraesophageal ganglion was performed with a sagittal section, splitbrain (SB).Results: The normal photo motor reflex in crayfish eye is measured as a gradual decrease in the ERG amplitude. During tactile stimulation, the visual activation of both eyestalks in normal crayfish leads to a highly regular bilateral activity. The regular activity can only be altered by disturbing the mechanoreceptors located in the shell surrounding the eyestalks.Conclusions: The procedure presented in this article provides unique characteristics for the study of the nervous system such as a detailed response of the bilateral optomotor reflex